抗菌药物管理 (AMS) 计划是提高抗生素处方质量的有效工具。它们的实施需要定期监测患者和机构层面的抗生素消耗情况。我们的研究捕获并分析了住院儿科患者的抗生素消耗密度 (ACD)。我们从德国急症护理医院 113 家儿科科室的医院药房收集了 2020 年抗菌药物消耗数据。 ACD 计算为每 100 个患者日 (pd) 的规定每日剂量（DDD，WHO/ATC 指数 2019）。此外，我们还分析了 2013-2020 年抗生素使用趋势。2020 年，所有参与医院的 ACD 中位数为 26.7 DDD/100 pd（范围：10.1-79.2 DDD/100 pd）。大学医院与非大学医院相比更高（38.6 vs. 25.2 DDD/100 pd，p<0.0001）。使用密度最高的是大学医院的肿瘤病房和重症监护病房（67.3 vs. 38.4 DDD/100 pd）。 2013 年至 2020 年期间，总体 ACD 下降 (- 10%)，头孢菌素处方也减少 (- 36%)。尽管如此，2020 年头孢菌素仍然是最常用的抗生素类别。头孢菌素/青霉素比率的医院间差异很大。属于 WHO AWaRe“观察”和“储备”类别的抗生素，包括广谱青霉素 ( 31%)、利奈唑胺 ( 121%) 和糖肽 ( 43%)，随着时间的推移而增加。不同抗生素的 ACD 和处方存在显着异质性头孢菌素类药物的类别以及高处方率和储备抗生素使用的增加表明抗生素处方质量正在改善。 AMS 计划应紧急优先考虑这些问题，以减少抗菌素耐药性。© 2023。作者。

Antimicrobial stewardship (AMS) programs are effective tools for improving antibiotic prescription quality. Their implementation requires the regular surveillance of antibiotic consumption at the patient and institutional level. Our study captured and analyzed antibiotic consumption density (ACD) for hospitalized pediatric patients.We collected antibacterial drug consumption data for 2020 from hospital pharmacies at 113 pediatric departments of acute care hospitals in Germany. ACD was calculated as defined daily dose (DDD, WHO/ATC Index 2019) per 100 patient days (pd). In addition, we analyzed the trends in antibiotic use during 2013-2020.In 2020, median ACD across all participating hospitals was 26.7 DDD/100 pd, (range: 10.1-79.2 DDD/100 pd). It was higher at university vs. non-university hospitals (38.6 vs. 25.2 DDD/100 pd, p < 0.0001). The highest use densities were seen on oncology wards and intensive care units at university hospitals (67.3 vs. 38.4 DDD/100 pd). During 2013-2020, overall ACD declined (- 10%) and cephalosporin prescriptions also decreased (- 36%). In 2020, cephalosporins nevertheless remained the most commonly dispensed class of antibiotics. Interhospital variability in cephalosporin/penicillin ratio was substantial. Antibiotics belonging to WHO AWaRe "Watch" and "Reserve" categories, including broad-spectrum penicillins (+ 31%), linezolid (+ 121%), and glycopeptides (+ 43%), increased over time.Significant heterogeneity in ACD and prescription of different antibiotic classes as well as high prescription rates for cephalosporins and an increased use of reserve antibiotics indicate improvable antibiotic prescribing quality. AMS programs should urgently prioritize these issues to reduce antimicrobial resistance.© 2023. The Author(s).